No abstract available.

BACKGROUND: EMLA cream is a eutectic mixture of lidocaine and prilocaine and has excellent anesthetic effect on tympanic membrane but histologic influence on tympanic membrane is uncertain. OBJECTIVE: To investigate its histologic effects on tympanic membrane. MATERIALS AND METHODS: 18 Sprague-Dawly rats were divided into 6 groups. Each group was treated with application of EMLA cream into external ear canal and then were sacrificed at 4 hours, 24 hours, 3 days, 7 days, and 14 days after application of the agents. RESULTS: 1) Transmission electron microscopy revealed partial loss of epithelial cell at 4 hours after application of the agents. 2) The specimen showed damaged cells in the epidermal layer and partial loss of basement membrane at 24 hours after application of the agents. 3) At 1 week after application of the agents epidermal layer and inner epithelium with connective tissue predominated. Thus the fibrous layer represent only 1/3 of total drum thickness. In the basal layers widened intercellular spaces were noted. 4) At 2 weeks after application of the agents newly formed connective tissue was found at fibrous layer and numerous fibroblasts were noted at inner epithelial layer. but overall histologic changes of the drum were not significant and healing processes was noted. CONCLUSION: EMLA cream has less histopathologic effects on tympanic membrane, and early recovery process occurred.
Anesthetics ; Animals ; Basement Membrane ; Connective Tissue ; Ear Canal ; Epithelial Cells ; Epithelium ; Extracellular Space ; Fibroblasts ; Lidocaine ; Microscopy, Electron, Transmission ; Prilocaine ; Rats* ; Tympanic Membrane*

PURPOSE: To report a case of bilateral scleral hyaline plaques in an elderly male patient. Scleral hyaline plaques are commonly noticed but rarely diagnosed. These are typical areas of hyalinization over the insertions of horizontal rectus muscle. CASE SUMMARY: A 75-year-old man presented to the hospital complaining of scleral color change. External examination of both eyes revealed oval, slate-gray lesions measuring approximately 3.5 mm in diameter, located just anterior to the insertion of the medial rectus muscle in both eyes. On anterior segment optical coherence tomography of the lesions, thinned sclera and plaque were observed. There was no change in the lesion on the 3-year follow-up visit.
Aged ; Eye ; Follow-Up Studies ; Humans ; Hyalin ; Male ; Muscles ; Sclera ; Tomography, Optical Coherence

Pneumocystis carinii causes serious pulmonary infection in immunosuppressed patients. This study was undertaken to observe the cytoskeletal proteins of P. carinii by immuno-electron microscopy. P. carinii infection was experimentally induced by immunosuppression of Sprague-Dawley rats for seven weeks, and their lungs were used for the observations of this study. The gold particles localized actin, tropomyosin, and tubulin. The actin was irregularly scattered in the cytoplasm of the trophic forms but was much more concentrated in the inner space of the cell wall of the cystic forms called the inner electron-lucent layer. No significant amount of tropomyosin was observed in either trophic forms or cystic forms. The tubulin was distributed along the peripheral cytoplasm and filopodia of both the trophic and cystic forms rather than in the inner side of the cytoplasm. Particularly, in the cystic forms, the amount of tubulin was increased and located mainly in the inner electron-lucent layer of the cell wall where the actin was concentrated as well. The results of this study showed that the cell wall of P. carinii cystic forms is a structure whose inner side is rich in actin and tubulin. The location of the actin and tubulin in P. carinii suggests that the main role of these proteins is an involvement in the protection of cystic forms from the outside environment by maintaining rigidity of the cystic forms.
Actins/analysis ; Animals ; Cytoskeletal Proteins/*analysis ; Fungal Proteins/*analysis ; Histocytochemistry ; Microscopy, Immunoelectron ; Pneumocystis/*chemistry/cytology ; Rats ; Rats, Wistar ; Support, Non-U.S. Gov't ; Tropomyosin/analysis ; Tubulin/analysis

PURPOSE: To investigate the comparison of retinal nerve fiber layer (RNFL) thickness and optic disc parameters measured by optical coherence tomography (Cirrus HD-OCT(R)) in dominant and non-dominant eyes. METHODS: Seventy-one subjects without underlying ocular disease were recruited for the present study. Ocular dominance was determined using the hole-in-the-card test. Comprehensive standardized eye examinations were performed. Scans of the optic disc and RNFL were performed using OCT. RESULTS: The mean intraocular pressure (IOP) of the dominant eye was higher than its counterpart (p = 0.025). No significant differences were observed in uncorrected visual acuity, refractive error and axial length between dominant and non-dominant eyes (p = 0.235, 0.180, 0.850). No RNFL and optic disc features were identified in the dominant from non-dominant eyes. CONCLUSIONS: Although dominant eyes tended to have higher IOP than non-dominant eyes, no consistent ocular structural differences between dominant and non-dominant eyes with the use of OCT were found.
Dominance, Ocular ; Eye ; Intraocular Pressure ; Nerve Fibers ; Refractive Errors ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity

BACKGROUND: Even though several oral anti-diabetic drugs (OAD) with various modes of action are replacing sulfonylurea (SU), some patients seem to be dependent on SU for adequate glycemic control. Therefore, we evaluated the clinical characteristics of such patients. METHODS: We selected the patients with type 2 diabetes who met following criteria from 2009 to 2014 at Seoul National University Hospital: glycated hemoglobin (HbA1c) was maintained below 7.5% for at least 6 months under small dose of SU (glimepiride < or =2 mg/day or equivalent dose); after discontinuation of SU, HbA1c increased > or =1.2% within 3 months or > or =1.5% within 6 months; and after resuming SU, HbA1c reduction was > or =0.8% or reduction of fasting plasma glucose was > or =40 mg/dL within 3 months. Patients with impaired hepatic or renal function, and steroid users were excluded. RESULTS: Nineteen subjects were enrolled: after averaged 4.8+/-1.5 months of SU-free period, HbA1c increased from 6.7%+/-0.4% to 8.8%+/-0.8% even though adding other OAD such as gliptins. However, HbA1c decreased to 7.4%+/-0.7% after resuming SU within 2.4+/-0.8 months. There was no sexual predominance. Despite their old age (67+/-11 years) and long duration of diabetes (18+/-10 years), fasting C-peptide was relatively well-reserved (3.9+/-2.6 ng/mL), and nephropathy was not observed (albumin-creatinine ratio 21.2+/-16.6 mg/g and estimated glomerular filtration rate 75.8+/-18.0 mL/min/1.73 m2). Strong family history was also noted (73.7%). CONCLUSION: Despite hypoglycemia risk of SU, it seemed indispensable for a subset of patients with regard to insulin secretion. Genetic influences would be evaluated.
Blood Glucose ; C-Peptide ; Diabetes Mellitus ; Dipeptidyl-Peptidase IV Inhibitors ; Fasting ; Glomerular Filtration Rate ; Hemoglobin A, Glycosylated ; Humans ; Hypoglycemia ; Insulin ; Seoul

A biloma is an extrahepatic or intrahepatic bile collection caused by traumatic, iatrogenic, or spontaneous rupture of the biliary tree. Prior reports have documented an association of a biloma with abdominal trauma and surgery, but spontaneous bile leakage associated with other primary causes has rarely been reported. A 72-year-old man was admitted to our hospital with the complaint of epigastric pain and yellowish discoloration of the sclera. Ultrasonography and computed tomography revealed a large fluid collection in the abdominal cavity. Endoscopic retrograde cholangiography demonstrated leakage of contrast medium from a distended segmental biliary branch in the left lobe of the liver. A perihepatic biloma was confirmed by sonographically guided percutaneous aspiration, and the patient underwent a left lateral segmentectomy of the liver, a cholecystectomy and T-tube choledochostomy. Histological examination showed left lateral bile duct hyperplasia, with abscess formation and chronic cholecystitis. Herein, a case of a biloma associated with choledocholithiasis is reported, with a review of the literatures.
Abdominal Cavity ; Abscess ; Aged ; Bile ; Bile Ducts ; Bile Ducts, Intrahepatic* ; Biliary Tract ; Cholangiography ; Cholecystectomy ; Cholecystitis ; Choledocholithiasis* ; Choledochostomy ; Humans ; Hyperplasia ; Liver ; Mastectomy, Segmental ; Rupture* ; Rupture, Spontaneous ; Sclera ; Ultrasonography

Early gastric cancer (EGC) is defined as a carcinoma confined to the mucosa or submucosa of the stomach, with or without lymph-node metastasis. Synchronous liver metastasis is 5~12.8% in advanced gastric cancer, but is very low in EGC. A 64-year-old woman was admitted to St. Vincent's Hospital with a complaint of epigastric pain. Gastrofiberscopic examination showed a polypoid mass on the gastric antrum. Abdominal computed tomography demonstrated an intraluminal polypoid mass in the gastric antrum, but no tumor mass in the liver. A laparotomy revealed a solitary liver metastasis, we performed a distal partial gastrectomy with a group-2 lymph-node dissection and resection of metastatic liver tumor. Histologic examination showed a tubular adenoma with a focal carcinomatous change, which was confined to the gastric mucosa and to the metastatic adenocarcinoma in the liver. We present a case of early gastric mucosal cancer associated with synchronous liver metastasis, along with a review of the literature.
Adenocarcinoma ; Adenoma ; Female ; Gastrectomy ; Gastric Mucosa ; Humans ; Laparotomy ; Liver* ; Middle Aged ; Mucous Membrane ; Neoplasm Metastasis* ; Pyloric Antrum ; Stomach ; Stomach Neoplasms

In an HIV-infected patient, cervical lymphadenopathy such as tubercuolosis, lymphoma, metastatic carcinoma must be differentiated from persistent generalized lymphadenopathy (PGL). Lymphoma is known as a late manifestation of HIV infection, generally occurring in patients with CD4+ T cell counts less than 200/microl. AIDS-related lymphomas were explained as variably associated with EBV infection, dysfunction of T cells, and HIV itself. The decision to perform a diagnostic open biopsy should be driven by a suspicion of malignancy or infection in the setting of a negative or inconclusive of FNA. Healthcare workers, especially those who deal with large numbers of HIV-infected patients, have a small but definite risk of becoming infected with HIV as a result of invasive procedures. Healthcare workers can minimize their risk of occupational HIV infection by following the guidelines discussed in this study.
Biopsy ; Cell Count ; Delivery of Health Care ; Epstein-Barr Virus Infections ; HIV ; HIV Infections ; Humans ; Lymphatic Diseases ; Lymphoma ; Lymphoma, AIDS-Related ; Lymphoma, Non-Hodgkin* ; T-Lymphocytes

BACKGROUND: Leptin, an adipocyte derived hormone, and thyroid hormone have similar effects on energy homeostasis, such that a shortage of both hormones is associated with decreased energy expenditure and increased body weight. Therefore, for the maintenance of energy homeostasis may require a close interaction between leptin and thyroid hormone. This study was performed to investigate the change in plasma leptin levels relating to short-term thyroid manipulation causing no significant change in body weight. METHODS: Hypothyroidism was induced by surgical thyroidectomy and hyperthyroidism by subcutaneous injection of 50 g of L-T3/100 g body weight/day, for 5 days, in 6~8 weeks old male Wistar rats. Body weights and food intakes were monitored daily until sacrifice. Plasma samples were collected, and the thyroid stimulating hormone (TSH), free triiodothyronine (T3) and leptin levels measured. The plasma leptin levels in rats with hypothyroidism and hyperthyroidism were compared with those of body weights at death and food intakes during the study, atched controls. RESULTS: The rats treated with L-T3 consumed equal amount of food as freely fed, rats but their final body weights were significantly lower (L-T3 treated 220.0 +/- 1.8 vs. freely fed 226.0 +/- 2.0 g, p<0.05). There was no difference in food intake during study, and final body weight, between the thyroidectomised rats and their paired controls (thyroidectomised 220.4 +/- 1.7 vs. paired 223.9 +/- 4.7 g, P=NS). Plasma leptin levels in the L-T3 treated rats were significantly lower than those in freely fed rats (L-T3 treated 1.7 +/- 0.1 vs. freely fed 4.8 +/- 0.2 ng/ml, p<0.005). Conversely, the thyroidectomised rats had higher plasma leptin levels, compared to those of their paired controls (thyroidectomised 4.8 +/- 0.3 vs. paired 1.7 +/- 0.1 ng/ml, p<0.005). CONCLUSION: The Plasma leptin levels in the rats were decreased by short term hyperthyroidism, while they were increased by short term hypothyroidism. These findings suggest that thyroid hormones may affect the production or secretion of leptin
Adipocytes ; Animals ; Body Weight ; Eating ; Energy Metabolism ; Homeostasis ; Humans ; Hyperthyroidism ; Hypothyroidism ; Injections, Subcutaneous ; Leptin* ; Male ; Plasma* ; Rats* ; Rats, Wistar ; Thyroid Gland* ; Thyroid Hormones ; Thyroidectomy ; Thyrotropin ; Triiodothyronine